Posterior Ethmoid Nodular Fasciitis

Area of Science:

• Oncology
• Pathology

Background:

• Nodular fasciitis (NF) is a rare, benign fibroblastic tumor often mistaken for sarcoma due to its rapid growth and cellularity.
• While typically occurring in adults, NF in children most commonly affects the head and neck region.
• The etiology of NF is unclear, but trauma is considered a potential trigger.

Observation:

• A six-year-old boy presented with a squint, leading to the incidental discovery of a posterior ethmoid sinus mass on CT scan.
• The patient had no history of trauma.
• Histopathology and immunohistochemistry confirmed the diagnosis of nodular fasciitis.

Findings:

• The case describes an unusual presentation of nodular fasciitis in the ethmoid sinus of a pediatric patient.
• The diagnosis was confirmed through imaging, histopathology, and immunohistological staining.
• Surgical biopsy was performed, and the patient showed no signs of recurrence one year post-operation.

Implications:

• This case underscores the importance of considering nodular fasciitis in the differential diagnosis of pediatric head and neck masses, even without a history of trauma.
• Accurate diagnosis through advanced imaging and pathology is crucial to differentiate NF from malignant neoplasms.
• Surgical management appears effective, with no recurrence observed in this case, suggesting a favorable prognosis for ethmoid sinus NF in children.